Department of Radiology, Obafemi Awolowo University (OAU)/OAU Teaching Hospitals Complex, Ile Ife, Nigeria.
Department of Internal Medicine, Obafemi Awolowo University (OAU)/ OAU Teaching Hospitals Complex, Ile Ife, Nigeria.
J Natl Med Assoc. 2018 Jun;110(3):256-264. doi: 10.1016/j.jnma.2017.06.001. Epub 2017 Jun 27.
Metabolic risk factors associated with non-alcoholic fatty liver disease (NAFLD) include Type 2 diabetes mellitus (T2DM), obesity and dyslipidaemia. Prevention or management of these risk factors with glycaemic control, weight reduction and low serum lipid levels respectively have been reported to reduce the risk of NAFLD or slow its progression. Since ultrasound (USS) is a safe and reliable method of identifying fatty changes in the liver, this study was done to determine the relationship between glycaemic control and ultrasound diagnosed NAFLD in T2DM.
Demographic data, anthropometric measurements and laboratory tests including glycated haemoglobin (HbA1c), fasting blood glucose (FBG) and serum lipids of 80 T2DM subjects aged 40-80 years were taken. Their livers were evaluated using B-mode ultrasound, and the data obtained were statistically analysed using SPSS version 20.
Fifty-five of all participants (68.8%) were diagnosed with NAFLD sonographic grades 1, 2 and 3 made up of 13 (16.3%), 26 (32.5%) and 16 (20.0%), respectively while 25 (37.2%) had grade 0. The prevalence of NAFLD in T2DM varied significantly with BMI (p = 0.001) and glycaemic control (p = 0.048) while the USS grades of NAFLD varied significantly with age (p = 0.043) and BMI (p = 0.006). The independent strong predictors of NAFLD were overweight (r = 0.409, p = 0.012, OR = 6.626) and obesity (r = 0.411 p = 0.009, OR = 11.508), while poor glycaemic control (r = 0.270, p = 0.015, OR = 3.473) was a moderate independent predictor.
The prevalence of NAFLD increases with increasing BMI and HBA1c in T2DM, while its ultrasound grade varies with BMI. Overweight, obesity and poor glycaemic control are independent predictors of NAFLD.
与非酒精性脂肪肝（NAFLD）相关的代谢风险因素包括 2 型糖尿病（T2DM）、肥胖和血脂异常。分别通过血糖控制、体重减轻和血清脂质水平来预防或管理这些风险因素，据报道可降低 NAFLD 的风险或减缓其进展。由于超声（USS）是一种安全可靠的方法，可以识别肝脏的脂肪变化，因此进行了这项研究，以确定 T2DM 中血糖控制与超声诊断的 NAFLD 之间的关系。
收集 80 名年龄在 40-80 岁的 T2DM 患者的人口统计学数据、人体测量学测量值和实验室检查结果，包括糖化血红蛋白（HbA1c）、空腹血糖（FBG）和血清脂质。使用 B 模式超声评估他们的肝脏，并使用 SPSS 版本 20 对获得的数据进行统计分析。
所有参与者中有 55 人（68.8%）被诊断为超声分级 1、2 和 3 的 NAFLD，分别为 13 人（16.3%）、26 人（32.5%）和 16 人（20.0%），而 25 人（37.2%）为 0 级。T2DM 中 NAFLD 的患病率与 BMI（p=0.001）和血糖控制（p=0.048）显著相关，而 NAFLD 的 USS 分级与年龄（p=0.043）和 BMI（p=0.006）显著相关。NAFLD 的独立强预测因素是超重（r=0.409，p=0.012，OR=6.626）和肥胖（r=0.411，p=0.009，OR=11.508），而血糖控制不佳（r=0.270，p=0.015，OR=3.473）是中度独立预测因素。
T2DM 中，NAFLD 的患病率随 BMI 和 HBA1c 的增加而增加，而其超声分级则随 BMI 而变化。超重、肥胖和血糖控制不佳是 NAFLD 的独立预测因素。
